Certolizumab Pegol in the Treatment of Psoriasis and Psoriatic Arthritis: Preliminary Real-Life Data

Abstract

Introduction: We present the results of real-life tests conducted in adults affected by psoriatic arthritis (PsA) with mild cutaneous involvement to evaluate the efficacy of certolizumab pegol (CZP), an anti-tumor necrosis factor-alpha agent approved in Europe for the treatment of rheumatoid arthritis and PsA.

Methods: Assessments included an evaluation of the Psoriasis Area and Severity Index (PASI) and the Disease Activity Score computed on 44 joints (DAS-44) correlated to the erythrocyte sedimentation rate (ESR) (DAS44-ESR). A total of 41 patients (16 men, 25 women; mean age 59.8 ± 8 years) completed the study. Of these, 36 patients were affected by both PsA and psoriasis, and five patients were affected only by PsA. A total of 32 patients (group A) completed 3 months of treatment (W12), and 12 patients completed 6 months of treatment (W24) (group B).

Results: The clinical efficacy of CZP was consistent on both the cutaneous and rheumatic components of the treatment. The mean PASI score decreased from 4.4 ± 4.7 at baseline (BL) to 2.3 ± 3.7 at W12 (group A), and from 5.1 ± 5.7 at BL to 0.8 ± 1.2 at W24 (group B). The DAS44-ESR decreased from 4.4 ± 0.6 at BL to a mean of 2.2 ± 0.9 at W12 (group A) and from 4.1 ± 0.6 at BL to a mean of 1.9 ± 0.5 at W24 (group B). No adverse events were reported.

Conclusion: Our results demonstrate that CZP can be used safely and effectively to treat both the cutaneous and joint components of PsA. However, long-term data are needed to confirm our preliminary observations.

Keywords: Anti-TNF-α; Biologics therapy; Certolizumab pegol; Psoriasis; Psoriatic arthritis; Real life data.

Fig. 1

Comparison of the Psoriasis Area and Severity Index (PASI) score, the Disease Activity Score computed on 44 joints (DAS-44), and the Pain Visual Analog scale (VAS) score for group A patients (32 patients who completed 3 months of treatment) at baseline (T0) and at 12 weeks of treatment (W12)

Fig. 2

Comparison of the PASI score, DAS-44, and pain VAS score for group B patients (12 patients who completed 6 months of treatment) at baseline (T0) and after 24 weeks of treatment (W24)

Fig. 3

Patients with dactylitis at baseline (a), response at W12 (b), and resolution at W24 (c)

Fig. 4

Patients with psoriatic plaque at BL (a), result after treatment at W12 (b), and result at W24 (c)

Fig. 5

Patients with psoriatic plaque on the trunk at BL (a), result after treatment at W12 (b), and result at W24 (c)